Have you been considering whether hormone testing will help you? There are a variety of different hormone tests and types. So how do you know which is relevant for you?
As a practitioner, I encourage my clients to track their symptoms first. Hormone testing is just the icing on the cake.
By tracking your symptoms throughout your cycle, you can start to identify which hormones might be out of balance. Once you have an idea of what is going on, you can test to confirm.
Let’s take a closer look and see if testing your hormones is useful and which is the type for your concerns.
When should you consider hormone testing?
There are several reasons why you might consider getting hormone testing done:
- You have a hormone-related condition. For example, you might have endometriosis, PCOS or PMDD. These conditions can be driven by different hormonal factors, so understanding your specific case is key to managing them.
- You want to know how your body is responding to hormonal contraception. Testing can indicate how your body is metabolising the contraceptive pill or Mirena, and whether it’s a good fit for you.
- You’re experiencing hormonal symptoms. This might be painful periods, PMS, a loss of your period, irregular periods or ovulation issues.
- You’re experiencing symptoms that could have a hormonal cause. This might include mood swings, anxiety, depression, weight loss or gain, acne or hair loss.
- You’re planning or trying to fall pregnant. Knowing where your hormones are at can tell you a lot, especially if you’re struggling to fall pregnant.
- You have a family history of hormone-driven cancer such as uterine, breast and ovarian cancer
- You want to check in on how your hormone balance is doing
Tests can include sex hormones, adrenal hormones, thyroid hormones, endocrine hormones such as insulin and metabolites.
The reason for hormone testing is important because it can help you decide the right test type for your needs. There is no point in testing everything if you don’t know what to do with the results!
That’s why it’s best to work with your healthcare professional for guidance.
The 3 main forms of hormone testing
If you’re looking to get hormone testing done, there are 3 ways you can go about this. Each has its uses and downfalls to consider.
Serum hormones
Serum, or blood testing, is the most common hormone testing you’ll come across. This reflects the amount of bound hormones present in the blood.
Serum testing is great for some tests. Common hormone testing done via serum include follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid hormones and endocrine hormones.
The downside of serum is that it is not a complete picture of what hormones are doing in your body. As it only shows bound levels, it can’t tell us what active hormones might be present and what they are doing. In this way, it’s a small snapshot of your hormones.
Serum testing is best for:
- Fertility testing – testing progesterone on day 21 of your cycle can give insights into whether you’re ovulating. On day 5, you can also test FSH and LH levels.
- Early-stage pregnancy – if you have a history of miscarriage, you’ll want to monitor your hormones through the early stages. Testing your progesterone levels around week 5-6 of your pregnancy can tell you if levels are building. If they aren’t, you can take action to correct it.
- Peri-menopausal testing – if you’re starting to see signs of peri-menopause such as heavy bleeding and infrequent periods, you can track your hormones to see where you’re at. High levels of FSH can indicate the onset of menopause. From here, you can look at options to support your hormones throughout the transition.
- Thyroid hormone testing – TSH, T4, T3, reverse T3 and thyroid antibodies can be assessed through blood testing
- Fasting insulin levels
Salivary hormones
Saliva testing looks at unbound active hormones in the body. It is the form of testing that I use most frequently in my clinic, as it gives a good ballpark of what the sex hormones are doing.
Saliva results may be affected by the use of topical creams. There is also a theory that when someone is under significant stress and salivary glands dry up, it can cause inaccurate adrenal results.
I have yet to see this occur in my own clients, but it is worth keeping in mind. As always, let your symptoms guide you and use the test as a tool to guide management.
Salivary testing is best for:
- A general picture of your hormone levels – you can check the 3 oestrogens, progesterone, testosterone and DHEA via saliva to get a good overview
- Hormonal conditions such as endometriosis, PCOS and PMDD – this can identify the imbalances driving the concerns
- Symptoms with hormonal causes – this includes those that may be hormone-driven such as acne, mood swings, anxiety and depression
Urine hormones (Dutch test)
Urine testing is also known as the Dutch test. It assesses what you are excreting through your kidneys.
Dutch testing is the most expensive, but is the gold standard for hormones. It can look at an array of hormones – inactive, active, stress hormones and metabolites. This allows us to get a good idea of what is going on in the body.
The downfall of urine testing is that it measures what we excrete after passing through the kidneys and liver. So if you have any health concerns that affect your detoxification and metabolism, or you’re using supplements that affect these processes, your results may be elevated.
Urine testing is best for:
- Cortisol – this is the form of testing used to diagnose conditions such as Cushing’s. It shows what is happening with the adrenal hormones throughout the day, rather than just one point.
- A family history of hormonal cancers – elevated metabolites can be a risk for those with ovarian, breast and uterine cancer in the family. But if we identify this as a problem, it allows us to start working on it and bring your risk down.
- Some symptoms related to hormones – cortisol metabolites can also be problematic for some. I often see clients with high cortisol metabolites experiencing brain fog as a result. It can also affect the right supplements for your adrenal concerns.
How much does it cost to get your hormones tested?
This depends on where you are located. In Australia, most serum tests can be covered by Medicare if you go through your local GP.
If you have hormone-related symptoms, a hormonal condition, or are wanting to fall pregnant, your GP will usually be happy to test the relevant hormones.
Sometimes, tests may not be covered. This can lead to out-of-pocket costs.
Saliva testing is around $160, depending on the company. This can be ordered through your naturopath or functional practitioner.
Urine is the most expensive test. It costs around $300 if you get the complete hormone option. This can be ordered through your naturopath or functional practitioner.
You can also order it yourself online. However, you will need to seek out a professional to help you interpret and tailor the results based on your history and case.
Want to get some hormone testing and get to the bottom of your concerns?
As a naturopath with extensive experience working with hormonal health, I’m here to help. Whether you need to decide the right testing for your needs or interpreting results, I can guide you on your journey to happy, balanced hormones.